Surgical instrument



Feb. 9,1926. 1 1,571,956

J. H. MOLINELLI SURGI CAL I NSTRUMENT Filed March 10, 1925 Patented Feb.9, 1926.

3' UNITED STATES. PATENT OFFICE.

JOHN H. OLIN LLI, or WEST PITTsToN, PENNSYLVANIA.

SURGICAL INSTRUMENT.

Application filed March 10,1925. Serial No. 14,357.

To allwhom it may concern: 1 I Be it known that 1, JOHN H. MOLINELLI, acitizen of the United States, residing in lVest Pittston, in the countyof Luzerne in the Stateof Pennsylvania, have invented certain new and.useful Improvements in Surgical Instruments, of which the following isa full, clear, and exact disclosure.

easily bent to any desired shape and whichwill automatically be bent andshape itself 1 tween the foetus and the soft parts of the while in useto conform to the and to the perineum.

A further ob ect of my invention is to presentation provide a metalinstrument which by reason of its pliability and flexibility, and lackof resiliency will distribute the pressure he perineum oversubstantially all of the posterior or recto-perineum so thattheliability .ot rupturing the perineum is greatly reduced.

A further ob ect of my invention is to provide an instrument. of. thecharacter above described, of thin smooth soft pliable.

non-resilient metal, which will shape itself to theihead or otherpresentation of the intent being delivered and protect the perineum,without injuringthe said other part of the presentation.

A further object of my invention is to provide an instrument of thecharacter above described, with a thin fiat shank or handle whichis alsoof the same and integral with the soft-pliable non-resilient metal ofthe handle'practically adjustable to conditions which vary in everyindividual case, andto make the main'or body portion of. the instruinentequally adjustable to the difierent varying conditions found in casesof'this character.

Otherobjects of my invention will ap pea in the specification and'claimsbelow.

Referring now to the drawingforming a part of this specification and inwhich the head or same reference characters are employed throughout thevarious views to designate the same parts,

Fig. 1 is a plan view of one embodiment or" my invention.

same.

Fig. 3 is a cross-sectional view on the line 3+3 of Fig. 1. '7 I a Fig.t is alongitudinal axial sectional view of the same after the handle hasbeen bent to fit the lingers of the surgeon and showing how the thumb ofthe surgeon is free. to apply pressure theretov to evenly press againstand stretch the soft parts of the perineum and i Fig. 5 is a viewsimilar to Fig. 4 but showing how the operating part of the instrumentmay be further slightly bent by the ,2 is a side elevational view of thesurgeon longitudinally it found desirable.

In the form of my invention shown in the drawing, the instrument whensubstantially straight as in Fig. 1, is preferably about eight or nineinches long and a little less.

than two inches wide in its widest part 1, the narrower half 2 beingarranged to be bent into a handle 2 as'will be referred to below.

' The larger or operating portion 1 is preterably slightly concavedtransversely as shown in Figs. 1 and 2 while the handle portion 2 may beand preferablyisat'ffirst straight and flat.

The forward edge is provided with smooth rounded corners 3, 8 and thecorners 4, 4:

where the width is decreased to form the handle 2 are similarly smoothand tapering. The instrument is preferably originally stamped out ot'arelatively thin sheet. of German sil er and then the-entire edge issmoothed and rounded as clearly indicated at in 2 and 3 so thattherewill be no sharp edges or corners or angles anywhere around themargin thereof. W hen the surgeon finds itdesrable to us the instrumenthe first manually shapes the operating portion 1 by curving ittransversely to an arc conforming to the general tranverse shape of theinner surface of the perineum of the patient'and he may bendit slightlylongitudinally if he finds it n'eces sary. or desirable in a. particularcase. He

then bends the handle into a more or less S-shape, that is he reverselycurves it longitudinally as shown in Figs. 4 and 5 to form'the upperloopor bend 6 and the lower mil-I loop 7 conforming to the shape, slant andsize of the lingers of the surgeon. This forms a handle which gives thesurgeon a very lirm and secure grip on the instrument insuring perfectand certain control of it for he may insert the index finger 8 and thelinger 10, second removed from the index linger 8, in the upper curvedportion (3 of the handle and the middle linger 9 (the one next the indexlinger 8) in the lower bend 7, leaving the thumb ll tree to be used topress on the concave upper surface oi the operating portion 1 withoutdestroying his lirm hold on the handle of the instrument. Having thusquickly shaped the instrument and propcrl y lubricated it, with thefingers al'ore said in the loops 6 and T and. the thumb ll above or alittle in advance of the ll'ltltli finger S, the surgeon can easily andwith certainty introduce the curved operative portion of the instrument,between labor pains, into the vagina, posteriorly over the perineum. Thethumb ll of the surgeon now free to be moved longitudinally of the concave portion 1 to substantially any position to apply pressure to anypart thereof and to further shape the portion more perfectly to theperineum and to stretch the same as may be found necessary, withoutrcleasing his iirm grip on the handle portion As the :loetus advancesand the head or other presentation reaches the perineum, the thin Germansilver o iierating portion 1. distributes the pressure over the entirerectoperineum and greatly reduced the liability to rupture or tearing ofthe perineum and at the same time the head or other presentation mayfurther bend the instrument to cont'orm more perfectly to the shape ofthe head.

The :foetus in advancing slips or slides over the lubricated operatingportion 1 withoutinjury to the head or other presentation or to theperineum.

Moreover, the instrument can be withdrawn iii desired be'l'ore completedelivery without injury to the mother or child as the surfaces are allsmooth, the edges are dull and the whole instrument is preferably welllubricated.

Af er having been used the instrument may be cleaned, sterilized andbent back to flat shape for convenient packing and transportation.

The device is clearly distinguished from that class of instruments whichare rigid and unbending, which are inserted anteriorly into the mouth ofthe uterus to deflect the head of the foetus 'iosteriorly oil the pnb'carch, for said class of devices are used as levers, to pry, move anddirect the lcetus. whereas both the operating part and handle o'l mydevice are not rigid but are pliable, freely bendable and non-resilientand earn not be used as a pry or lever. My instrumcnt substantiallyforms a metal cover, protector or strengthener extending over therccto-perincum to strengthen the same, to distribute the pressure and toprevent the tearing and rupture of the perineum during parturition.

Thus I have provided an instrument for the purposes above described inwhich the main or operating portion may be readily bent transverselyinto arcuate or cylindrical form of any desired adius, and can belongitudinally manually curved slightly as occasion may rcc'luire, andwhich is of soft pliable non-resilient metal formed with a continuousrounded marginal edge and without any sharp angular edges or corners,the

corners being provided with smooth slow curves which will not scratch,cut or scrape the delicate surface on which it is adapted to be used.

Since the normally flat handle is made of the same flexiblenon-resilient material as the ope 'ating portion, it may readily be sobent and fitted around and between the lingers ol" the user as to insurea firm and sure grip on the instrument when in use notwithstamling thefact that the instrument may be completely covered by and with asuitable lubricant. The instrument so lubricated will not slip or changeits position with respect to the hand of the surgeon even when the thumband possibly the index linger also may be temporarily employed for otherpurposes than grasping the handle of the instrument.

rrlthough I have illustrated and described one way in whichthe handlemay be bent in and around the lingers of the user, it is evident that itwould probably seldom be bent twice to exactly the same shape, and thatdifferent operators might bend it in some other way to insure a firmgrip on the instrument under different conditions and such changes arefully within the aim and scope of the present invention. The operatingportion may also be made in different sizes and in slightly varyingdetails and be within the spirit of my invention.

\Vhile I have found that German silver is a metal which is well adaptedto the purposes oi this instrument, I do not wish to be construed aslimited strictly to the use of this metal therein, since othernon-corrosive alloys and materials, having the requisite strength,combined with ready pliability and non-resiliency, and capable ofreceiving and retaining a smooth polished surface may be employedwithout departing from the aim and scope of my invention as defined inthe appended claims.

Having thus described my invention, what I claim and desire to protectby Letters Patent ot the United States is:

1. An obstetrical instrument ma-de entirely of thin flexiblenon-resilient sheet metal and comprising an elongated nearly flatoperating portion readily manually bent and shaped transversely into anarcuate or cylindrical form, and a normally flat handle freely bendableto conform to the shape, size and position of the fingers of any user,said instrument being provided with a continuous smooth rounded dullmarginal edge 'fre from corners or sharp angles. 4

2. An obstetrical instrument having an elongated nearly flat operatingportion 'readily manually bent and shaped transelongated operatingportion readily manual- 1y bent and shaped transversely into an arouateor cylindrical form, and a handle integral therewith, said instrumentbeing composed throughout of non-resilient sheet metal and having anoperating portion, thin and flexible enough to be automatically shapedby the pressure between the presentation and the perineum to conform tothe shape of the presentation and of the perineum and of a size todistribute the pressure substantially evenly over the perineum, thehandle also being easily manually bendable transversely t0 the axisthereof to fit around and conform to the shape, size and position of anyoperators fingers.

4. An obstetrical instrument having an elongated operating portioncurved trans versely and also slightly curved longitudinally to providea concave upper surface and a convex under surface, and a-handleintegral therewith, said instrument being composed throughout ofnon-resilient sheet metal, said operating portion being thin andflexible enough to be automatically bent by the pressure between thepresentation and the perineum to conform to the shape of thepresentation and of the perineum and of a size to distribute thepressure substantially evenly over the perineum.

5. An obstetrical instrument having a handle and a smooth operatingportion of thin flexible non-resilient sheet metal of substantially thesize and of the shape in general of the inner surface of an extended andstretched perineum, and adapted to be placed between the presentationand the perineum to strengthen, to protect and to distribute pressureover the perineum, during parturition to prevent rupture of theperineum.

6. An obstetrical instrument having an operating portion and a. handleof normally flat thin, flexible non-resilient sheet material adapted tobe readily bent and wrapped around and between the fingers of any userto prevent the slipping of the instrument with respect to the hand ofthe operator while being used.

In testimony whereof, I have hereunto set my hand this sixth day ofMarch, 1925.

JOHN H. MOLINELLI.

